In the late 1950s, the state opened the South Florida State Hospital in Pembroke Pines as a treatment facility for people suffering from severe and persistent mental illnesses such as schizophrenia and major depression. But by the late 1980s, the hospital had become little more than a human warehouse where the mentally ill wandered about naked and shared toothbrushes from a communal bucket. When passers-by complained of seeing nude patients from the street, state workers responded by painting the hospital’s windows black. Patients sat idle; therapy was almost non-existent.

A class-action lawsuit in 1988 produced some improvements, but a decade later the hospital was still dysfunctional. Patients often wandered off the grounds, and the hospital lacked good treatment programs. Ineffective treatment meant few patients could be discharged. With few beds opening up, incoming patients faced a yearlong wait to be admitted.

Fed up, the state Legislature and then-Gov. Lawton Chiles decided in 1997 to privatize the facility. At the time, Wackenhut Corrections, a south Florida-based company that operated 21 correctional facilities, including two prisons in the state, was looking for new opportunities from privatization of government services. After learning of the state’s desire to privatize the south Florida hospital, Wackenhut purchased an 87-bed, private psychiatric hospital in Fort Lauderdale for $6 million and spun off a company, Atlantic Shores Healthcare, to provide mental health services.

Before GEO
Care took over South Florida State Hospital, the average stay for the facility’s mentally ill patients was 8 1/2 years. Today the average stay is less than a year.

In November 1998, Atlantic Shores was awarded the contract to take over the state hospital, which became the first state mental hospital in the nation to be turned over completely to a private company.

The results? While the state isn’t achieving big savings [“Cost of Care,” below], privatization has improved services to some of its sickest, most vulnerable citizens at a facility once considered unmanageable. The company, meanwhile, now doing business as GEO Care, has been able to leverage its success at the south Florida hospital into additional contracts in Florida and New Mexico — and possible contracts in other states like Nevada, Georgia and Utah that are considering privatizing the operation of mental health facilities.

Cost of Care

An analysis by the Department
of Children and Families revealed little difference between the cost of
private and state-run forensic facilities, which are for the treatment of people in the criminal justice system who are mentally ill. Most have been adjudicated incompetent to proceed or found not guilty by reason of insanity. The costs ranged from about $330 to $360 per bed day ($120,000 to $130,000 per bed year). The cost breakdown: 85% salaries and benefits, 5% prescribed medicines and 10% other costs, such as food and other expenses.